Multiple Sclerosis - Treatment

Treatment of MS takes two forms. First, although there are no drugs that
will actually cure the disease, there are drugs that can slow down the
course of MS. Second, a variety of treatments can be used to ease the
symptoms of multiple sclerosis.

As of 1997, three drugs had been approved for use with multiple
sclerosis: Avonex, Betaseron, and Copaxone. All three reduce the rate of
relapses in the relapsing-remitting form of MS. Each has other benefits
as well. Avonex may slow the progress of physical damage; Betaseron may
reduce the severity of symptoms; and Copaxone may decrease disability.
All three drugs are administered by injection.

Immunosuppressant drugs have also been used to treat severe relapses.
These drugs act on the immune system directly, causing it to work less
effectively. The drugs carry some risks, so a patient may have to be
hospitalized during treatment.

MS causes a large variety of symptoms. For that reason, many different
treatments may be necessary to relieve those symptoms. A person should
be vaccinated against influenza (see influenza entry). The vaccination
can help protect against respiratory (breathing) problems, thus reducing
the symptoms of MS. Preventing complications from MS is also important.
Such complications include pneumonia (see pneumonia entry), bed sores,
injuries from falls, or urinary infections. These complications lead to
death more often than does MS.

Physical therapy is important in treating MS. It helps the patient
strengthen and retrain affected muscles, maintain range of motion to
prevent muscle stiffening, learn to use assistive devices such as canes
and walkers, and learn safer and more energy-efficient ways of moving
and sitting.

A program of physical therapy usually includes exercise and stretching.
These activities can be taught and practiced at home. Swimming is often
recommended. It provides a way for a patient to get exercise without
becoming overheated.

Treatment programs usually include occupational therapy as well. People
with MS are taught how to deal with daily activities, such as dressing,
feeding, and washing. The occupational therapist can make suggestions
for arranging the home and work environment so that an MS patient can
function more safely and efficiently.

An MS patient may need training in bowel and bladder control. Drugs are
sometimes used to deal with these problems. They help the patient to
empty his or her bowel and bladder on a more normal schedule.

Spasticity can be treated with drugs as well. Baclofen (pronounced
BAK-lo-fen) and diazepam (pronounced di-AZE-uh-pam, trade name Valium)
are given by mouth, while botulin toxin (Botox) is given by injection.
These drugs can help relieve the pain caused by spasticity. Back pain
can be treated with over-the-counter pain relievers, such as aspirin or
acetaminophen (pronounced uh-see-tuh-MIN-uh-fuhn, trade name Tylenol),
or with physical therapy.

Fatigue can be treated by having the patient plan and follow a regular
daily routine. The routine should allow for frequent rest periods. Drugs
such as amantadine (pronounced uh-MANT-uh-deen, trade name Symmetrel)
and pemoline (pronounced PEM-uh-leen, trade name Cylert) can help
improve alertness and lessen fatigue. Corticosteroids are used to treat
visual problems. Other types of drugs can be used to treat seizures,
vertigo, and tremor.

Alternative Treatment

A variety of alternative treatments have been recommended for multiple
sclerosis. So far, there are few scientific data to support most of
these claims. For example, bee venom has been suggested as a treatment
for MS. But studies have not supported this claim. Marijuana has been
recommended for the relief of certain symptoms of MS, including tremor,
pain, and spasticity. But the drug has side effects of its own. It is
not widely recommended in the United States for the treatment of MS.

Some practitioners suggest that high doses of vitamins, minerals, and
other dietary supplements can help slow the progress of MS. Specific
nutrients recommended include linoleic (pronounced lin-uh-LEE-ik) acids,
selenium, vitamin E, and a diet low in saturated fats.

Lane Phalen, a multiple sclerosis sufferer, with her service dog.
The dog helps her with daily activities that have become difficult
because of MS. (Reproduced by permission of

AP/Wide World Photos

)

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